The San Francisco Department of Public Health told the Health Commission that it has applied to the Centers for Medicare & Medicaid Services (CMS) for a waiver covering 120 Laguna Honda Hospital (LHH) beds and is awaiting a CMS decision without a definitive timeline.

Director of Health Grant Colfax informed commissioners that the department "applied, following the process, as instructed, by CMS" for the waiver and that the Laguna Honda team will provide updates, including at the next Health Commission meeting on Jan. 13. Colfax did not provide a timeline because CMS has not shared one.

Why it matters: Public commenters and several commissioners pressed DPH for more transparency and more rapid action on admissions to Laguna Honda, noting concerns about long waits for people who need nursing-home level care.

Public comment and concerns

- Patrick Monet Shaw, a public commenter, said he filed records requests for mock-survey documents and alleged that SFDPH records staff had denied some requests citing California Evidence Code section 115. Shaw expressed concern that refusal to release mock-survey results "suggest to observers that LHH potentially still has major problems in patient care and safety, and LHH is hiding something."

- Dr. Teresa Palmer, a caller from the public record, asked whether the department is pursuing the waiver for the 120 beds and, if not immediately, what barriers exist. She also raised concerns about admissions pace and reports of an applicant being advised to disenroll from insurance without advice on how to seek exceptions, and asked whether admissions staff are assisting people with insurance or Medi-Cal navigation.

DPH response and staffing changes

- Colfax announced the hiring of Diltar Sedoo (transcript spelling), who has been acting nursing home administrator, as chief nursing home administrator for Laguna Honda Hospital. A public commenter later questioned Sedoo's past experience; one caller said Sedoo's first job as a nursing home administrator was at a facility that closed.

- Colfax and staff described department actions to apply for the waiver and said they have "confirmed with CMS that they have everything they need to make a decision" but that CMS provided no timeline.

Commissioner questions

Commissioners asked whether changes in federal administration could affect the speed of CMS review; Colfax said he could not speculate and reiterated that the department had submitted required materials and was awaiting a decision. Commissioners also raised questions about admission pace and whether DPH's admission processes could be accelerated.

Ending

Commissioners directed staff to report back with updates on the waiver application and admissions metrics at future meetings. Public requesters reiterated a demand for release of mock-survey documents and additional transparency about admission processes.